Neoplastic Disorders, Infectious Disorders, Cutaneous signs of systemic Conditions Flashcards Preview

MSS Weeks 3-5 > Neoplastic Disorders, Infectious Disorders, Cutaneous signs of systemic Conditions > Flashcards

Flashcards in Neoplastic Disorders, Infectious Disorders, Cutaneous signs of systemic Conditions Deck (73)
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1

What bacterial infections of the skin did we talk about?

Impetigo

Staphylococcal scalded skin syndrome

Cellulitis (Deep pyogenic infection)

Erysipelas

2

What viral infections of the skin did we talk about?

Verrucae (Warts), Human papilloma virus

Condyloma accuminatum

Herpes Simplex Virus (HSV-1/HSV-2)

Varicella Zoster Virus (Chicken pox/Shingles)

Molluscum contagiosum

 

3

What arthropod reactions of the skin did we talk about?

Scabies (Sarcoptes scabiei)

 

4

What fungal infections of the skin did we talk about?

Superficial fungus (Dermatophytosis) (Tinea)

Tinea versicolor

5

What epidermal, melanocytic, lymphoid neoplasms of the skin did we talk about?

Epidermal:

Sebhorrheic Keratosis

Actinic Keratosis

Squamous Cell Carcinoma

Keratoacanthoma

Basal Cell Carcinoma

Melanocytic Tumors:

Acquired and Congenital Melanocytic Nevi

Sporadic and Familial Dysplastic Nevi

Melanoma

Skin Lymphomas

Mycosis Fungoides

 

6

What is Impetigo?

With whom is it seen?

What causes it?

How does it present?

Where does it present?

Common superficial bacterial skin infection that is highly infectious.

Mostly seen in childhood or immunocomp adults

Staph aureus most common (Strep pyogenes less)

Small vesicles burst and replaced by thick yellowish crust (Honey colored)

Mouth, nose, extremities most commonly affected.

7

Impetigo

Histo: Spongiotic epidermis with neutrophilic infiltrate

Clinical: Honey colored thick yelloish dirty crust with margin of erethema

8

What is Staphylococcal Scalded Skin Syndrome?

In whom is it seen?

What causes it?

Clinical presentation?

Where is it clinically present?

What is it associated with?

Toxin-mediated type of exfoliative dermatitis causing intraepidermal splitting through the granular layer

Seen in infant and children

Caused by 2 exotoxins, ET-A and ET-B (Epidermolytic Toxin) from Toxigenic strains of Staph aureus

Sudden onset of skin tinderness and macular eruption followed by development of large flaccid bullae. 

Face, neck, trunk, axillae, groin. MUCOUS NOT INVOLVED

Though rarely in adults, associated with renal disease/inability to clear the toxin and may result in fatal staphylococcal septicemia

9

Staphylococcal Scalded Skin Syndrome

Histological: Subcorneal splitting of the epidermis, a few acantholytic cells and sparse neutrophils present within blister

10

What is cellulitis (Deep pyogenic infection)?

Where is it common on the body?

What causes it?

What is the clinical presentation?

Diffuse inflammation of the connective tissues of the skin and/or the deeper soft tissues

More common on legs

Beta-hemolytic streptococci and/or coagulase positive staphylococci

Expanding area of erythema (tender)

11

Cellulitis (Deep pyogenic infection)

Histologically: In both cellulitis and erysipelas there is marked dermal edema and lymphatic dilatation. Also diffuse infiltrate of neutrophils accentuated around blood vessels 

12

What is Erysipelas?

How does it clinically present?

Where does it commonly clinically present?

What organism commonly causes it?

Distinctive type of cellulitis, a bacterial skin infection involving upper dermis (Superficial cutaneous lymphatics)

Sharply outlined edematous erythematous tender and painful plaques

More common on lower exptremities and in elderly

S. pyogenes is most common

13

Erysipelas

Histologically: In both cellulitis and erysipelas there is marked dermal edema and lymphatic dilatation. Also diffuse infiltrate of neutrophils accentuated around blood vessels 

14

What causes Verrucae (warts)?

What is the result of warts?

What are the different types of Verruca?

What are the different types of HPV?

What is the pathology?

Human Papilloma Virus (DNA virus)

Self limited, regressing spontaneously w/in 6mo-2yr

Verruca Vulgaris (hands commonly)/Verruca plana (face or dorsal surface of hands)/Verruca plantaris/Verruca palmaris

Low and High risk HPV (verruca caused by low-risk)

Verrucous epidermal hyperplasia/Koilocytosis of upper layer of epidermis/Keratohyaline granules and intracytopasmic aggreg

15

Verruca (warts)

Verrucous epidermal hyperplasia

Koilocytosis (cytoplasmic vacuolization) of the upper layer of epidermis

Infected cells show keratohyaline granules and intracytoplasmic aggregates

16

What is Condyloma Accuminatum?

What other HPV types are of note and why?

Clinical presentation?

Sexually transmitted disease caused by HPV 6 and 11

High risk HPV types 16, 18, 31, 33 may increase risk for cancer

Single or multiple papular lesions that are pearly, filiform, fungating, cauliflower, or plaquelike

 

17

Condylomata acuminata

Histologically: characterized by marked acanthosis with a broad rounded exophytic growth. Surface of the lesion is hyperkeratotic parakeratotic

18

What is Varicella-zoster virus and what does it cause?

What causes it?

Pathology of Varicella

Pathology of Shingles

DNA Herpesvirus (lipid-enveloped DS) that causes Chickenpox and Shingles

HSV-1 (common in childhood, lips) and HSV-2 (genitalia, sexually transmit)

Varicella spreads through respiratory route. Rash progresses from macules to vesicles to pustules.

Shingles is recurrence of VZV in adulthood. Unilateral dermatomal distribution in thorax and lumbar

19

Herpes Simplex and VZV show same histologic changes

Acantholysis of epidermis

Multinucleated keratinocytes with intranuclear inclusions (Cowdry Type A inclusions)

Perineurial and intraneurial inflammation

20

What is a Tzank Smear

Rapid cytological diagnosis done by making a smear from the base of a freshly opened stain ( of HSV) and staining it with Giemsa stain.

 

Not as sensitive

21

What is Molluscum contagiosum?

Where is it seen?

Pathology?

Cutaneous infection caused by large brick shaped DNA poxvirus

Children acquire from close contact (eyelids, face, axilla) and immunocompromised patients (HIV). Penis vulva groin as STD

Pathology: Inverted nodule "crater-like"/Eosinophilic cytoplasmic bodies (Molluscum bodies or Henderson-Patterson bodies)

22

Molluscum Contagiosum

 

23

What is Scabies and how is it spread?

How does it present and where and when?

Contagious caused by the mite Sarcpotes Scabiei, transmitted via prolonged direct human contact and rarely by fomites

Presents as extremely pruritic papulovesicular eruption

Fingers/penis/umbilicus/waistband/axilla/hands

Erupts 4 wks after infestation

24

Scabies

Fertilized female deposits eggs in burrows in the epidermis. Extend at shallow angle through stratum corneium an dmay reach deeper epidermis.

25

What is tinea/dermatophytosis?

What are the 3 genera?

How does it present?

What test would you use to identify?

What are the different tineas?

Very common superficial cutaneous infections by fungus

Microsprum/Epidermophyton/Trichophyton

Scaly, erythematous plaques, annular

KOH prep rapid test to find branching septate hyphae

Tinea capitis (scalp)

Tinea corporis (trunk/back)

Tinea barbae (beard)

Tinea cruris (groin)

Tinea pedis (feet)

26

Tinea

Histologically: variable. Presence of sandwich sign (hyphae sandwiched between normal basket weave stratum corneum and a lower layer of stratum corneum with eitehr orthokeratotic or parakeratosis)

PERIODIC ACID SCHIFF (PAS) STAIN CAN REVEAL THE FUNGUS

27

What is Tinea versicolor?

Where is it common?

What causes it?

How is it presented?

A common superficial fungal infection.

Tropical climates and in summer months

Malassezia globosa

Multiple irregular areas of hypo or hyperpigmentation which are CIRCULAR AND MACULAR

28

Tinea versicolor

Histologically: Stratum corneum contains round budding yeasts and short septated hyphae imparting spaghetti and meatballs appearance. 

Seen clearly in H&E and PAS preparations

29

What are Seborrheic keratoses?

Where are they commonly found on the body?

What causes it?

What is a condition involving multiple of these and what is it assoc with

Pigmented papules and plaques with "stuck on" appearance (warty)

Common on face, trunk, and upper extremities

Harbor activating mutations in fibroblast growth factor FGF receptor 3

Leser Trelat sign, associated with internal malignancies (stomach cancer)

30

Seborrheic Keratosis

Histologically: Hyperkeratotic, papillomatous, verrucous epidermis.

Presence of horn and pseudo horn cysts is characteristic

Variable melanin pigmentation accounting for brown coloration